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PRACTICE CHANGER Consider prescribing a single dose of corticosteroids for patients with sore throat, which has been found to bring quicker pain relief and resolution of symptoms. STRENGTH OF RECOMMENDATION [...]

Background. Streptococcal pharyngitis, caused by group A [beta]-hemolytic streptococci (GABHS), is among the most common infections seen by primary care physicians. Because the illness can result in rheumatic fever, early eradication of infection is important. Penicillin has been the standard treatment for GABHS pharyngitis for over four decades, but reports of bacteriologic failure with this drug in recent years have led to trials of alternative antimicrobials. Methods. In this investigator-blind, randomized multicenter trial (30 centers), oral clarithromycin, 250 mg twice daily, or oral penicillin VK, 250 mg three times daily, was given to outpatients [is greater than or equal to] 12 years old with GABHS pharyngitis as documented by positive cultures for Streptococcus pyogenes and positive rapid immunoassay tests. The clinical and bacteriologic efficacy of clarithromycin was compared with that of penicillin in the 356 evaluable patients. Safety analysis was performed in all patients who had received at least one dose of the study drug (N = 453). Results. Overall, clinical outcomes were comparable in the two groups. However, more clarithromycin-treated patients than penicillin-treated patients had resolution of sore throat (94% vs 86%, P = .014) and disappearance of pharyngeal erythema and exudate (89% vs 82%, P = .05). Bacteriologic cure rates were higher in clarithromycin-treated patients (95% vs 87%, P = .009). No serious adverse events were observed in either group. Conclusions. This study suggests that clarithromycin twice daily is as effective and as well tolerated as penicillin in the treatment of streptococcal pharyngitis., Streptococcal pharyngitis is caused by Streptococcus pyogenes, a group A [beta]-hemolytic streptococcus (GABHS), and is among the most common conditions treated by primary care physicians in the United States.[1] An [...]

SAN DIEGO -- Antibiotic prescribing for adults with sore throats declined from 75% of visits in 1989 to 70% of visits in 1998, a reduction that hasn't done much to [...]

Dieter A, Horst S, Helmerking M. Short-course antibiotic treatment of 4782 culture-proven cases of Group A streptococcal tonsillopharyngitis and incidence of poststreptococcal sequelae. J Infect Dis 2000; 182:509-16. * BACKGROUND [...]

NEW YORK -- Management of pharyngitis is "extremely important and surprisingly controversial," Dr. Alan L. Bisno said at a meeting on infectious diseases sponsored by the Center for Bio-Medical Communication. [...]

SAN FRANCISCO -- Penicillin remains the treatment of Choice for acute streptococcal pharyngitis despite its failure to eradicate the streptococci in one-third of children in a large prospective study, the [...]

PRACTICE CHANGER Consider prescribing a single dose of corticosteroids for patients with sore throat; this has been found to provide quick pain relief and resolution of symptoms. (1) STRENGTH OF [...]

Bulloch B, Kabani A, Tenebein M. Oral dexamethasone for the treatment of pain in children with acute pharyngitis: a randomized, double blind, placebo-controlled trial. Ann Emerg Med 2003; 41:601-608. * [...]

The paper by Schrock in this issue of the Journal draws our attention once again to the problems surrounding the management of the patient with tonsillopharyngitis caused by group A [...]

The optimal dose of azithromycin for the treatment of group A streptococcal tonsillopharyngitis in adults is 500 mg/day for 3 days, a metaanalysis of randomized controlled trials suggests. A total [...]

Confirming an infection by culture can reduce unnecessary antibiotic use among children with pharyngitis caused by group A [beta]-hemolytic streptococci (GABHS), said Maria Carmen G. Diaz, M.D., and her associates [...]

GREENWICH, CONN. -- Oral dexamethasone can help relieve the pain associated with moderate to severe pharyngitis in children and adolescents, Dr. Robert P. Olympia reported at a meeting of the [...]